Rossendale House Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this newly registered service. This key question has been rated good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. Staff spoke positively of the culture of this service. Comments included, “Good values and well run” and “Training is good, training is always ongoing, continuous learning all the time and support.” A range of policies and procedures were in place and accessible to staff. Policies were displayed in staff areas including safeguarding and whistleblowing policies to ensure all staff knew the steps to take should they have concerns.

An awards scheme for staff evidenced the service’s values and beliefs and when staff won an award, they received a badge with the service’s core values on as a reminder of the service’s vision. The service’s key values are passionate, caring and teamwork. The registered manager told us, “Our strategic goals are to deliver safe, high-quality, person-centred care, continuously improve our service, achieve positive regulatory outcomes, develop and retain a skilled workforce and provide residents with the best possible quality of life.” The registered manager was open and honest about the challenges they faced; including staff recruitment. There was an open and honest culture at this service where staff felt able to raise concerns freely without discrimination ensuring people received the best possible outcomes.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. Staff praised the strong leadership team at this service. Comments included, “The (registered) manager is very approachable, I have recently been sick, and I have been reassured by the (registered) manager and deputy manager. I feel heard and understood” and “I love the (registered) manager, (she is) always on the end of the phone, always responds to messages and if there is ever a problem or an emergency they answer the phone straight away. Both the (registered) manager and care manager are on call.” Staff told us action was taken immediately by the registered manager to address any issues and felt they were competent and knowledgeable in their role as well as supportive.

The registered manager told us they were supported by higher management to ensure they undertook their role effectively. They said, “I have access to a wide range of support and development opportunities and feel well supported by the provider. I receive regular support from the operational director, regional director, quality director and the regulatory assurance manager who provide guidance, oversight and challenge, where needed.” Access to trainingand development opportunities meant the registered manager could enhance their skills and confidence to ensure effective leadership. This ensured people received the best possible care from a competent and well led leadership team.

Staff received support through regular check-ins and supervisions. Supervision forms were detailed and gave staff a chance to speak and reflect about how situations could have improved, what was going well and any agreed objectives.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. We saw evidence of regular staff feedback provided through surveys and team meetings. A meeting took place every morning with the registered manager, deputy manager, catering, maintenance, administrator and unit leads. The purpose of the meetings was to discuss any issues that might have occurred, discuss any safeguarding, incidents, accidents and various other topics to ensure the registered manager had oversight of the running of the service. We saw evidence of regular team meetings where concerns were discussed, upcoming events and gave staff an open and safe space to discuss any pressing issues. Staff completed surveys to share their views which evidenced positive comments made by staff. Surveys were anonymised so staff could express their views freely.

Access to policies including the whistleblowing policy were made available in staff spaces. Staff said, “We have regular staff meetings which I find helpful. I feel listened to and not afraid to speak up.” The registered manager spoke of the importance of having a visible management team and an open-door approach to encourage staff, people and relatives to speak up about any concerns.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Staff told us they were treated fairly. They said, “I am treated well as a staff member, they (managers) would accommodate any needs.” One staff member spoke of how their working hours had been amended to accommodate personal circumstances which had improved their wellbeing and work life balance.

Policies and procedures were in place in relation to equality and diversity and staff had undertaken training in this area. The registered manager spoke of ensuring reasonable adjustments were in place for staff who needed it and advice would be sought from Occupational Health should this be required.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. Staff told us the service was well managed. They said, “There is a lot of support from (deputy manager) and (registered manager). I can always go to them for questions. They help me out a lot.”

Thorough and comprehensive audits were in place which provided a percentage of compliance followed by any actions that needed to be undertaken. A manager was allocated the action which was then signed off with a completion date. Audits were clearly effective in driving improvements and ensuring good standards of care were delivered. Audits were being completed at all leadership levels to ensure effective oversight and continuous learning and improvement. Learning from audits and incidents were shared amongst the staff team. We saw evidence of meetings taking place when concerns were found and team discussions of how risks could be prevented in the future.

A service improvement plan was in place and picked up concerns found during this assessment as well as dates to be compliant by. This evidenced an open culture and awareness from leaders at all levels of improvements that needed to be made. It was clear staff had confidence in managers at all levels, and we saw members of the leadership team had recently carried out face 2 face training with staff to enhance their skills and knowledge.

We did however find concerns relating to staffing levels and although this had been picked up on audits, it wasn’t clear what action was taken to address the issues mentioned in this report of long nurse call bell waits and people waiting for long periods in the dining room. We have since received assurances from the provider as mentioned earlier on in this report.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. Staff told us the service and leadership team were transparent and there was an open culture. The service had close links to the local community to ensure people did not feel isolated. The registered manager said, “We support residents to access community groups and services where this meets their needs and wishes. Our lifestyle team arranges regular outings and encourages residents to take part in local community events, visits to cafes, parks and places of interest.”

We saw evidence of people being supported out into the community. This ensured people felt engaged with the world outside of the service and resulted in positive outcomes for people. Partner agencies told us the service interacted well with them through shared learning.

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. Staff praised the training and development opportunities at this service and staff were encouraged to champion in certain areas to enhance their skills and knowledge. They said, “I had an interview and I am now becoming a dementia champion. I have 4 days training, and I have put a presentation together to learn how to train other staff. Dementia experts become responsible for creating memory boxes. It is really lovely and a good opportunity.” The registered manager spoke highly of the champion schemes and was looking at expanding this to further strengthen staff knowledge.

We saw evidence of detailed lessons learnt processes. These outcomes were shared with staff during supervisions and meetings and used to ensure better outcomes for people. It was clear the leaders of this service genuinely wanted to learn from mistakes and improve to ensure people received the best possible outcomes. The registered manager said, “We have a range of quality assurance systems to monitor performance, identify trends and drive improvement. Progress is monitored through governance processes, and learning is shared with the team through meetings, handovers, and supervisions to ensure improvements are embedded and sustained.”

Partner agencies told us the service engage well and were always looking to expand their knowledge. They said, “Rossendale House have engaged with our service where we have set up learning opportunities.”